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J G Valdivia Uría

Publications and source records attributed to J G Valdivia Uría.

At least 19 recordsLinked to original sources
PubMed2005

[Analysis of the absorcion's factors of irrigating fluid during transurethral resection of the prostate].

OBJECTIVES: In this study it was our intention to evaluate the relation between the reabsorption of irrigating fluid and three variables: time of the intervention, volume of solution of glicina employee and weight of the fragments, during the RTU of prostate fulfilled to low hydraulic pressure. MATERIAL AND METHOD: We study 74 patients that RTU of prostate was performed with suprapúbica derivation with Amplatz's pod 30 ch. The ethanol was monitored in expired air every 15 minutes during the intervention. Likewise we annotated the time of the intervention, the volume of glicina used and the weight of the fragments extracted. Statistically Anova's text was in use for comparison of averages. RESULTS: 13,6% of the patients absorbed irrigating fluid in some quantity. The range of absorption belongs to 100 cc until 2.000 cc. We did not find a statistically significant difference in the averages of time of resection, volume of glicina and weight of the fragments between the group of patients that had absortion of irrigating fluid and they that didn't had. CONCLUSIONS: Our data show that the operative time, the volume of irrigating fluid and the weight of the resected fragments do not influence the reabsorption of liquid of irrigation when a RTU is realized to low hydraulic pressure.

Absorption↗
PubMed2004

[Quality analysis of the statistical used resources (material and methods section) in thesis projects of a university department].

INTRODUCTION AND OBJECTIVES: Studies about quality in thesis and investigation projects in biomedical sciences are unusual, but very important in university teaching because is necessary to improve the quality elaboration of the thesis. The objectives the study were to determine the project's quality of thesis in our department, according to the fulfillment of the scientific methodology and to establish, if it exists, a relation between the global quality of the project and the statistical used resources. MATERIAL AND METHODS: Descriptive study of 273 thesis projects performed between 1995-2002 in surgery department of the Zaragoza University. The review realized for 15 observers that they analyzed 28 indicators of every project. Giving a value to each of the indicators, the projects qualified in a scale from 1 to 10 according to the quality in the fulfillment of the scientific methodology. RESULTS: The mean of the project's quality was 5.53 (D.E: 1.77). In 13.9% the thesis projects was concluded with the reading of the work. The three indicators of statistical used resources had a significant difference with the value of the quality projects. DISCUSSION: The quality of the statistical resources is very important when a project of thesis wants to be realized by good methodology, because it assures to come to certain conclusions. In our study we have thought that more of the third part of the variability in the quality of the project of thesis explains for three statistical above-mentioned articles.

Academic Dissertations as Topic↗
PubMed2004

[Transurethral prostatic resection with bipolar scalpel].

UNLABELLED: FUNDAMENTAL: [corrected] To show our initial experience in the TUR of prostate with bipolar axipolar bistoury. MATERIAL AND METHODS: Five patients with an average age of 72 years old, were operated between may and june 2002. They showed important increased in questionnaire symptoms (IPSS). The average ecographic volume has been 57.4 g. We employed Gyrus resector and physiological salt solution for continue irrigation. RESULTS: The average operative time was 70 minutes. None of the patients showed hyponatremia needed blood transfusion. In all the cases the sound was removed 48 hours after operation, one of them have urinary retention (UR) and need sound tow more days. Hospital stay was tree days except the patient how had UR. At 1 and 6 month there is improvement in the IPSS. CONCLUSIONS: TUR of prostate with bipolar axipolar bistoury can avoid the secondary effects of glicine and allows us to work with prostates of bigger volumes due to we have more time to do it. Nevertheless bigger and better studies are required to value the effectiveness of this new technology opposite the TUR of prostate with monopolar bistoury which keeps being the gold standard.

Aged↗
PubMed2003

[Modified technique for transurethral resection of the prostate with suprapubic drainage and local anesthesia].

PURPOSE: To establish a technique for transurethral resection of the prostate (TURP), combining the use of local anaesthesia with an Amplatz suprapubic tube, in patients at high surgical risk. MATERIALS AND METHOD: A study was carried out in 32 patients who underwent TURP with a 30 F Amplatz suprapubic tube following local anaesthesia. This technique was indicated where surgery presented a general risk, in elderly patients, and for patients refusing to undergo spinal intradural or general anaesthesia. The mean age of the patients was 70 years (61-82 years). The risk of surgery was assessed according to the ASA classification. RESULTS: According to the ASA classification, 7 patients were ASA III (21.9%), and 25 patients were ASA IV (78.1%). In 31 of the 32 patients the operation was completed in one session. When questioned about the pain they felt, 11 patients reported no pain, 12 slight discomfort and 3 occasional pain. In the latter three patients, intravenous sedation was enhanced with 0.1 mg etomidate per kg body weight. The volume of the resected fragments ranged from 18 to 120 ml, with a mean of 47 ml, except in one patient with 205 ml who required two treatment sessions. CONCLUSIONS: Large prostate resection in patients at high surgical risk was performed comfortably using a combination of local anaesthesia and an Amplatz suprapubic tube. This procedure is one possible option to be considered as an alternative to other treatments.

Adenocarcinoma↗
PubMed2002

[Endoscopic surgery in urology].

At this moment in time, endourology is incorporating extraluminal endoscopic techniques (laparoscopy, lumboscopy, retziuscopy), which the urologist is expected to master. The current advanced stage of development of intraluminal endoscopic surgery is mainly due to the most recent technological achievements (miniaturization of the lens, the use of more versatile materials and new energy sources). In the current cystourethroscopic procedures, compact endoscopes and flexible cystoscopes play an important role. The most important of these new techniques include tissue vaporisation procedures, interstitial application of substances or energies, low-pressure transurethral resection and percutaneous vesical surgery. Upper endoluminal procedures have been the ones to most benefit from modern technological developments. The most important features of present day ureterorenoscopes and their clinical applications are studied and also those of percutaneous nephroscopy (lithiasis, neoformations and others). In a review on the current situation of extraluminal endoscopy, a wide range of laparoscopic techniques--applicable to adrenal regions, kidneys, ureters, retroperitoneal and lymphatic systems, testicles and sperm ducts, bladder and prostrate gland--are discussed as well as the indications, advantages and drawbacks involved and the preferential surgical approaches.

Endoscopy↗
PubMed2000

[Laparoscopic approach through optic trocars].

OBJECTIVE: Laparoscopy has not reached the same levels of development in Urology as it has in other surgical specialties. Consequently, the average urologist is not sufficiently accustomed to using laparoscopic trocars, a difficulty which becomes even more noteworthy since treatment is occasionally preferably by the extraperitoneal approach (preperitoneoscopy and retroperitoneoscopy). Our experience with different visualizing trocars is presented. METHODS: We reviewed our experience with different visualizing trocars. The advantages and inconveniences of each type, utilized in different approaches, are discussed. RESULTS: Active visualizing trocars are preferred because they are safe and permit pre and retroperitoneal blunt dissection without difficulty. However, cost is the major disadvantage of these instruments because they are not reusable. CONCLUSION: Lately, we are more inclined to utilize the reusable visualizing trocars with the helicoidal cannula, which are very safe for the transperitoneal and perhaps slightly less for the extraperitoneal approach. These instruments cause less injury when they go through the abdominal wall and, furthermore, they cost less.

Equipment Design↗
PubMed1998

Technique and complications of percutaneous nephroscopy: experience with 557 patients in the supine position.

PURPOSE: Percutaneous nephroscopy is usually performed with the patient prone, which is uncomfortable for the patient and does not prevent damage to the colon. We assess the possibility of performing percutaneous nephroscopy using local anesthesia with the patient supine, and evaluate the advantages and complications. MATERIALS AND METHODS: A total of 557 consecutive percutaneous nephroscopies were attempted in 221 men and 242 women in the supine position. Patient age ranged from 8 to 87 years (mean 55.1). Patients are supine with a 3 l. serum bag below the ipsilateral flank. We catheterize the affected uretheral meatus with a 5F catheter through a flexible cystoscope. The tract is infiltrated with local anesthesia. The skin is punctured in the posterior axillary line which corresponds to approximately 1 cm. above the bag. We use an Alken set to dilate the tract to 30F, which is the size of the Amplatz sheath we commonly use. RESULTS: Nephroscopy was performed in 519 cases (93.1%). Mean operation time was 85 minutes (range 15 to 240). Serious bleeding occurred in 3 cases. The colon was never damaged in patients treated in the supine position. CONCLUSIONS: Percutaneous nephroscopy using local anesthesia with the patient supine is safe and easy. According to our experience the advantages in comfort to the patient and feasibility to the surgeon justify its use.

Adolescent↗
PubMed1994

[Nephrectomy through lumbar endoscopy. Report of 3 cases].

After a long experience with transperitoneal laparoscopic surgery of the kidney, we have incorporated the Gaur balloon technique for dissection. We report our experience of 3 nephrectomy procedures performed via lumboscopy, with the patients lying in the lumbotomy position. A 12 mm skin incision is made in the axillary midline. Blunt dissection of the muscle planes is carried out and the retroperitoneal space is explored digitally. A 16 F balloon-tipped catheter is introduced and the balloon is distended with 720 ml saline solution. The catheter is removed and a Hasson trocar with optics and 3 accessory trocars are inserted. The kidney is dissected and the elements of the vascular pedicle are clipped or stapled independently. The kidney is fragmented inside a Lapsac and removed. In our view, this procedure is easier to perform and carries less morbidity than transperitoneal laparoscopic nephrectomy.

Adult↗
PubMed1993

[Experience with endoscopic urethrocervicopexy: long-term results].

With the purpose of evaluating the long-term results of percutaneous endoscopic urethrocervicopexy performed in our unit since 1987, using a modified Stamey's technique, in the treatment of stress urinary incontinence in women, 51 patients who had undergone surgery up to June 92 were retrospectively studied. Mean time since surgery was 35 months, and satisfactory results during this time were accomplished in 60.5%, bearing in mind that the patients are totally "dry" and do not require sanitary towels. Comparison of our results and those contributed by other authors in the literature, indicating the decrease over time in the number of good results, and that between three to four years after intervention, the stress urinary incontinence reappears in one third of the women. Finally, we try to provide an statistical correlation of the cases in which continence was not achieved, including the patient's personal features or their medical-surgical background.

Cervix Uteri↗
PubMed1992

[Laparoscopic cystoprostatovesiculectomy and ureterosigmoidostomy. Experimental surgical model].

The authors have performed 26 experimental laparoscopic cystoprostatovesiculectomies in pigs, 17 of which were followed by ureterosigmoidostomies, also laparoscopically. Using a 10 mm trocar at the umbilical level (optics), another 10 mm at the hypogastric level (pliers and titanium staple applicator), a third 5 mm in left iliac fossa (pliers) and another 5 mm in right iliac fossa (electric shears), cystectomy is performed with a routine technique: stapling and section of deferents, umbilical arteries, vesical lateral pedicles and prostate-seminal pedicles. A double ligature precedes the section of the urethra in the pelvian fundus. A plier passed within an Amplatz jacket (previously introduced through the anus) assists the laparoscopic ureterosigmoidostomy "in elephant trunk" which is performed by sero-muscle suture using 3-zero reabsorbable single-strand material. Overcoming the anatomical differences existing with humans, the illustrated experimental model confirms the possibility of performing this type of procedures in human beings, which would considerably curtail the morbidity associated with this type of surgery.

Animals↗
PubMed1992

[Laparoscopic nephrectomy: experimental surgical model].

Presentation of 39 experimental laparoscopic nephrectomies carried out in pig. With the animals under general anaesthesia and using 4 laparoscopic trocars the authors dissected the kidney and clipped separately the ureter, renal arteria and vein. Once these elements were sectioned, they placed the kidney inside a small plastic pouch (introduced within the peritoneal cavity through one of the trocars) and after extracting its neck through the hole in the abdominal wall created by the 11 mm trócar, they performed different intra-abdominal fragmentation procedures on the extirpated kidney. Following fragmentation testing with a 7 and 10 mm punch, resectoscopic electric loop, arthroscopic cutter and ultrasonic tissue aspiration procedures, they concluded stating that an increase in the power of these last equipment would convert them into an ideal procedure for laparoscopic exeresis of any intra-abdominal organ.

Animals↗
PubMed1991

[Postoperative sclerosis of the bladder neck: pathogenic mechanisms].

A study was conducted in 69 patients with postoperative sclerosis of the vesical neck to analyze the different pathogenic mechanisms that have been put forward. This complication, however, could not be ascribed to any underlying cause. It presents in patients who undergo surgery of the prostate early, when their adenoma is generally small and frequently with inflammatory lesions as those of chronic prostatitis. Surgery appears to be the triggering mechanism in these patients who are likely to be predisposed to developing this condition as some patients are predisposed to develop keloid from cicatricial hypertrophy.

Adult↗
PubMed1991

[Endoscopic ureterectomy].

Endoscopic ureterectomy is a minimally invasive surgical technique indicated in cases warranting ureterectomy to complement extended nephrectomy for pyelocaliceal urothelial carcinoma. The results achieved are identical to those of conventional ureterectomy (open surgery) without the inconvenience or sequelae that usually present with the latter procedure. In 1982, the authors developed the modified Dell'Adami and Breda endoscopic ureterectomy technique. To date, they have performed their modified technique in 10 cases: 9 with infiltrating urothelial or highly malignant pyelic or caliceal tumor and 1 with diffuse leukoplasia and cholesteatoma of renal pelvis. The technique described herein permits intussusception of the ureter into the bladder by transurethral traction of a Chevassu ureteral catheter to which that cephalad end of the ureter is attached during the extended nephrectomy procedure. Once intussusception of the ureter has been achieved, a resectoscope is used to cut the ureter at the level of the ureteral meatus. Thereafter the mucosa of the corresponding trigonal horn is completely resected. The results are highly satisfactory in patients whose ureter has not previously been submitted to open surgery and is not compromised by tumor spread.

Aged↗
PubMed1991

[Percutaneous endoscopic urethrocervicopexy].

A minimally invasive surgical technique that remarkably simplifies the Stamey procedure is described herein. The technique shortens the operating time and achieves a success rate of over 80%. Thus, we believe this technique should be considered in the treatment of stress urinary incontinence in females.

Adult↗
PubMed1991

[Acquired hydrocele in the adult: sclerotherapy].

We report our experience in the treatment of hydrocele using sclerosant therapy in 50 patients with adult acquired hydrocele (AAH) or cord cyst (CC). The sclerosing agent utilized in all of the patients was quinacrine dihydrochloride (quinacrine) at a dose of 13.3 mg 50 cc aspirated volume. The results were assessed clinically, ultrasonographically and thermographically. The presence of multilocular cysts or incomplete aspiration of the liquid was the most frequent cause of failure. The results show a success rate of 85%; however, 18% required more than one treatment.

Adult↗
PubMed1991

[Postoperative sclerosis of the bladder neck: surgical treatment].

We analyzed the results of surgical treatment of vesical neck sclerosis in 81 patients who underwent 97 procedures. Most of these patients had post-operative sclerosis of the vesical neck. The different surgical techniques and their results are reviewed. Excision of the sclerotic tissue by transurethral encircling resection has been the most widely used and has achieved better results. It is frequently necessary, however, to use it together with other complementary techniques such as retrograde resection, knife incision, or combined procedures. Knife incision of the diaphragm has achieved the worst results. Overall, the results have been poor (approximately 36% poor results). The results achieved by these procedures are even worse (75% poor results) in recurrence.

Adult↗